Provider Demographics
NPI:1629043708
Name:VALLEY HEALTH SYSTEMS INC
Entity Type:Organization
Organization Name:VALLEY HEALTH SYSTEMS INC
Other - Org Name:VALLEY HEALTH COAL GROVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE / CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARY-BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUBECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-525-3334
Mailing Address - Street 1:2585 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25703-1642
Mailing Address - Country:US
Mailing Address - Phone:304-697-1396
Mailing Address - Fax:304-697-2086
Practice Address - Street 1:205 MARION PIKE
Practice Address - Street 2:
Practice Address - City:COAL GROVE
Practice Address - State:OH
Practice Address - Zip Code:45638
Practice Address - Country:US
Practice Address - Phone:740-532-1188
Practice Address - Fax:740-532-1183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH103T00000X, 261QF0400X, 363LF0000X
OH34004625207V00000X
208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0998694Medicaid
KY7100087500Medicaid
OH0094868Medicaid
WV0035230000Medicaid
WV511841Medicare Oscar/Certification
OH0094868Medicaid